Sudden cardiac death during exercise due to an isolated multiple anomaly of the left coronary artery in a 12-year-old girl: clinicopathologic findings.

A 12-year-old girl was taken to the Virgen Macarena Universitary Hospital in Seville, Spain, complaining of abdominal pain, nausea, palpitations, and difficulty in breathing. Her school teacher informed that the girl collapsed after a 100-m race at sports in school. Emergency rescue personnel found the patient pale, in a cold sweat, with low peripheral perfusion. Initial ECF revealed supraventricular tachycardia (150 bpm), right bundle branch block and left anterior hemiblock that, eventually, progressed to full cardiac arrest. At autopsy, an isolated multiple congenital anomaly of the left coronary artery was found (initial segment anomaly; course anomaly and tunneled coronary artery anomaly). In our opinion, this appears to be the first reported case of exercise-related sudden cardiac death, due to an isolated multiple congenital anomaly of the left coronary artery (at the origin, on the course and at the termination).